Predictive and Prognostic Role of Metabolic Response in Patients With Stage III NSCLC Treated With Neoadjuvant Chemotherapy.
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
/ drug therapy
Female
Fluorodeoxyglucose F18
/ metabolism
Glycolysis
Humans
Lung Neoplasms
/ drug therapy
Male
Middle Aged
Neoadjuvant Therapy
/ methods
Neoplasm Staging
Positron Emission Tomography Computed Tomography
/ methods
Prognosis
Radiopharmaceuticals
/ metabolism
Response Evaluation Criteria in Solid Tumors
Retrospective Studies
Tumor Burden
/ drug effects
18F-FDG PET/CT
Metabolic response
Neoadjuvant treatment
Non–small-cell lung cancer
Prognostic value
Journal
Clinical lung cancer
ISSN: 1938-0690
Titre abrégé: Clin Lung Cancer
Pays: United States
ID NLM: 100893225
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
06
03
2019
revised:
10
07
2019
accepted:
14
07
2019
pubmed:
15
8
2019
medline:
2
4
2021
entrez:
15
8
2019
Statut:
ppublish
Résumé
The purpose of this study was to assess the predictive and prognostic role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in candidates with stage III non-small-cell lung cancer (NSCLC) to neoadjuvant chemotherapy. Sixty-six patients with stage III NSCLC treated with induction chemotherapy from March 2013 to December 2017 were retrospectively identified. Response assessment were evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and European Organisation for Research and Treatment of Cancer (EORTC) criteria. 18F-FDG PET/CT metabolic parameters were analyzed as absolute values as well as percentage changes (Δ) between 2 consecutive scans, for primary tumor (T) and for regional lymph nodes (N). All clinical variables and metabolic parameters were compared with treatment response and correlated with progression-free survival (PFS) and overall survival (OS), based on a median follow-up of 9.4 months. Post-induction therapy standardized uptake value (SUV)max_T, SUVmean_T, metabolic tumor volume (MTV_T), and total lesion glycolysis of the tumor (TLG_T) varied significantly between responders and non-responders (6.6 vs. 13.8; P = .001; 4.2 vs. 8.1; P < .001; 6 vs. 17.9; P = .002; and 24.1 vs. 136.3; P < .001, respectively). Likewise, percentage changes (Δ_T) were significantly different between the 2 groups (P < .001). Along with primary tumor, also post-SUVmax_N, post-SUVmean_N, and post-TLG_N (P = .024, P = .015, and P = .024, respectively), as well as all percentage changes (Δ_N) were different between responders and non-responders. RECIST 1.1 and EORTC response classifications were discordant in 27 patients (40.9%; κ = 0.265; P = .003). On multivariate analysis, post-TLG_N was an independent predictor for both PFS and OS, whereas RECIST 1.1 was a predictor only for OS. Several metabolic parameters may differentiate responders from non-responders following neoadjuvant chemotherapy in stage III NSCLC. As compared with RECIST 1.1, EORTC seems to be more appropriate for evaluation therapeutic response. Finally, post-TLG_N has significant prognostic information.
Identifiants
pubmed: 31409523
pii: S1525-7304(19)30208-6
doi: 10.1016/j.cllc.2019.07.004
pii:
doi:
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
28-36Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.